Laser Skin Resurfacing

Laser Treatments for Wrinkles

Laser resurfacing is one of the most common treatments used for wrinkles and acne scars today. Like many things in cosmetic surgery, laser resurfacing goes by several names: wrinkle laser, lasabrasion, laser peel, laser surgery, laser vaporization, laser resurfacing, and several others. All of these terms mean the same thing: they refer to the use of the laser to treat wrinkles and acne scarring.

Laser Resurfacing: The Good News

Laser surgery for wrinkles accomplishes improvement in wrinkles and acne scars. Some lasers accomplish this by vaporizing superficial damaged skin cells and allowing the remaining collagen to become thicker and healthier. As a result, fine wrinkles will be removed and dynamic wrinkles will be improved. Acne scars will appear less obvious. The CO2 laser will also tighten your skin, smooth your skin texture, improve your complexion, and possibly your skin color.

Laser Resurfacing: The Bad News

Unfortunately, laser surgery is not a panacea. Your wrinkles and acne scars will improve but will not simply vanish, and several treatments may be required to achieve the result you desire. Also, (in spite of what you may have read elsewhere on the web), recovery from some laser procedures is not a snap (more below).

Laser Surgery: How and Why It Works

To understand why the laser works, you must first appreciate some basics about your wrinkles and acne scars. Wrinkles and acne scars share one very important feature: they are lower than the surrounding skin. Because of this, light casts shadows in them, making them visible. Look in the mirror to convince yourself. You will see that everywhere there is a wrinkle or acne scar, there is a shadow. If all wrinkles and acne scars were flush with the level of the skin, the eye would not see them because there would be no shadow. Laser resurfacing works because it makes the wrinkles (acne scars) less visible by vaporizing the surrounding skin (as in the case of CO2 and Erbium) and by stimulating collagen production which makes wrinkles less deep (as in the case of the CO2 and Erbium laser). Because your skin is vaporized (due to the CO2 or Erbium lasers), it is like a true burn. Your skin will be oozing and weeping. The deeper your wrinkles and acne scars, the more treatments you will need. Shallow wrinkles and scars may be vanished with one treatment.

While some may claim that certain other lasers offer dramatic or profound results, be wary. Many lasers treat only a small fraction of the skin (ie. Fraxel®) or heat the underlying skin layers (ie Thermage®). These lasers result in minimal improvement in your skin that lasts for a very short (a few months) period of time.

Choosing a laser is a very personalized decision and depends on how much improvement you want and how much recovery time you can afford. Carbon dioxide (CO2) laser resurfacing is generally the most effective form of skin resurfacing, but imposes far greater recovery time than most other available treatment options. Some longer wavelength lasers cause less resurfacing and therefore shorter recovery, but with more deep heating and collagen stimulation than a CO2 laser. Some tunable dye lasers result in purely deep tissue heating and collagen stimulation without any resurfacing. With the myriad of different lasers available for skin treatment, it can be very confusing when seeking treatment. Dr. Bowman will be certain that you understand the differences in various laser treatments, and why certain types of lasers will be more or less suited to meeting your needs and desires.

Preparation for CO2 or Erbium Laser Resurfacing.

Preparing your skin for laser resurfacing is critical to optimizing your result and recovery. Retin-A, glycolic acid, and bleaching agents (hydroquinones) available through our office will help prepare your skin for laser resurfacing. They will reduce your risk of discoloration, speed healing, and optimize your cosmetic result. You should use these products consistently for at least six weeks prior to your procedure. After your skin heals from the laser, you should resume these skin care products throughout your period of redness.

Recovering From Your Laser Surgery

  • Anesthesia: General or sedation (topical anesthesia may be used for some erbium procedures)
  • Length of surgery: 15-90 minutes.
  • Length of stay: Outpatient (home same day).
  • Discomfort: Anticipate 1-4 days of prescription pain medication.
  • Swelling: lasts 3 days to three weeks.
  • Dressings: Treated areas will appear as abrasions or deep burns. They will weep, ooze, and hurt when uncovered.
  • Healing: Your skin will heal in 4-6 days following erbium laser and 5-14 days following carbon dioxide laser. It will then appear sunburned. The only problem is that this “sunburn” takes awhile to fade. Redness will improve over 1-4 weeks following erbium and 1-4 months following CO2. Once your skin heals you can wear camouflage make-up to conceal the redness. Interestingly, as much as everyone hates to be red, the longer you are red, the better your final result.
  • Presentable in public: You will be presentable with makeup in 7-14 days.
  • Sun protection: SPF 15 or higher for 3-6 months.
  • Resume skin care: You may resume skin care products after your skin has healed.
  • Final result: Will be seen after your redness has faded, approximately one week to four months.
  • Next laser treatment: You should wait at least 6 months between laser treatments.